Provider Demographics
NPI:1669585204
Name:LANTZ, SHARON PILATI (LPC)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:PILATI
Last Name:LANTZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:B
Other - Last Name:PILATI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:300 MEDICAL DR FL 2
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-1765
Mailing Address - Country:US
Mailing Address - Phone:757-788-0092
Mailing Address - Fax:757-788-0969
Practice Address - Street 1:4445 CORPORATION LN STE 200
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-3262
Practice Address - Country:US
Practice Address - Phone:757-213-6961
Practice Address - Fax:757-687-0702
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701002821101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA49-45573Medicaid
VA49-45573Medicaid